High Psychiatric and Medical Comorbidity in Youth with Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder

Comorbidity among youth with bipolar (BP) disorder and attention-deficit/hyperactivity disorder (ADHD), particularly in clinical settings, is the rule rather than the exception. The following is a brief, clinically focused overview of BP and ADHD and their comorbidity with substance use disorders (SUD), anxiety disorders, and medical problems. Both BP and ADHD have high prevalence rates of comorbid substance use disorders (in the realm of 50%) and anxiety disorders (35%–60%) that negatively impact prognosis, and thus deserve specific treatment, but few guidelines exist. Both BP and ADHD are associated with significant medical comorbidities—related to the disorder itself, and secondary to pharmacotherapy—that also require careful consideration, close monitoring, and prompt treatment. Both BP and ADHD have a relatively small evidence base to guide treatment of psychiatric comorbidities but nevertheless require a dual focus when planning treatment, concurrently and/or sequentially. In summary, when it comes to comorbidities, both BP and ADHD carry a substantial burden. Future treatment studies focusing on comorbidity are warranted to guide clinical decision-making in real-world samples that are characterized by comorbidity. [ Psychiatr Ann. 2014; 44(10):459–465.]